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NHS Trust
University Hospitals of Leicester
GP Newsletter
June
NEW... GP hotline goes online...When you submit your request it will be actioned in real time between the hours of 09.00-18.00 (Monday to Friday).
You now have two options available to you:1. GPs can ring 0116 258 48 58 (press option 2)2. Use the online form, which can be found by clicking here: http://www.leicestershospitals.nhs.uk/professionals/gp-hotline-online-request-for-help/
We hope you find this useful.
GP hotline... review the first monthThe hotline went live at 9am on Wednesday 9th May; the detail below is the progress between the 9th May and Thursday 31st May 2012.
Total GP calls received93
No. of outpatient appointments saved
No. of outpatient appointments saved as a %
27 29% No. of admissions saved No. of admissions saved as a % 16 17%
The price of an outpatient appointment or admission can vary considerably depending on the specialty and condition of the patient, on the basis of 27 outpatient appointments and 16 (emergency) admissions avoided at the Trust average rate, this has saved:
• 27 new outpatient appointments - £4,406• 16 emergency admissions - £33,857Total = £38,263 Total calls by category
I need to speak to (Average ring back time: 10 minutes) 57 Information I have received is unclear 10 I would like a copy of 9 Other 9 When will my patient be seen 6 I cannot find 2 Totals 93
Total calls: I need to speak to - by service areaCardiology 5 Neurology 6Diabetes & Endocrinology 1 Obstetrics / Gynaecology 3ENT 2 Oncology 1Gastroenterology 7 Ophthalmology 2 Geriatrics 2 Orthopaedics 2 Haematology 5 Paediatrics 3 Heptology 1 Radiology 1Max Fax 1 Rheumatology 2 Medicine 4 Surgery 4Nephrology 1 Vascular 3Totals 57
Total calls made to GP hotline by practice
16 Fosse Road South 147 Melbourne Road 2705 Aylestone Road 1Anstey Surgery 1Asquith Surgery 4Barwell & Hollycroft Medical Centre 4Bowling Green Surgery 1Bushloe End Surgery 2Central Surgery 3Countesthorpe Health Centre 1Downing Drive Surgery 6East Leicester Medical Practice 2Evington Medical Centre 2Forest House Medical Centre 2Freeman’s Common Health Centre 1Groby Road Medical Centre 2Hazlemere Medical Centre 1Heath Lane Surgery 1Highfield Medical Centre 1Highgate Medical Centre 1Inclusion Healthcare 1Johnson Medical Practice 7Latham House Medical Practice 2Manor House Surgery 1Manor Medical Centre 1Oakmeadow Surgery 2Pinfold Gate Medical Practice 1Saffron Surgery 1Sayeed Medical Centre 2Shefa Medical Practice 1Silverdale Medical Practice 2Spinneyhill Medical Centre 1South Wigston Health Centre 2St Matthews Health & Community Centre 1Station view Health Centre 1Student Health Centre 1Syston Health Centre 2The Charnwood Practice 1The County Practice 5The Limes Medical Centre 2The Willows Medical Centre 1The Wycliffe Medical Practice 1Willowbrook Medical Centre 13Woodbrook Medical Centre 2Totals 93
Following GP feedback you can now log a request for help on our website.
Gynaecology Emergency Patient Pathway Information for GPs
The withdrawal of this service follows the latest guidelines and follows discussion with our Gastroenterology colleagues, who are in agreement that the laboratory FOB service should be withdrawn. In light of current National Guidelines and evidence, we plan to withdraw offering the FOB service as from the end of July 2012. Many pathology laboratories in the UK have already discontinued offering FOB testing. In summary, the evidence against the use of FOB testing is as follows:
1. NICE Guidelines for Referral for Suspected Cancer (CG027, sections on upper and lower gastrointestinal cancer) state that when referring, no examinations or investigations other than abdominal and rectal examination and full blood count are recommended, as this may delay referral.
2. Detection of occult blood in faeces is both insensitive and non-specific in the investigation of colorectal cancer:
• False negatives (risk of false reassurance, and may delay diagnosis)- ‘Sampling error’ e.g. intermittent GI bleeding- High doses of vitamin C
• False positives (risk of unnecessary patient anxiety, and over investigation)
- Presence of animal haemoglobin and myoglobin in stool due to diet
- Presence of plant peroxidase activity in stool due to diet e.g. horseradish, turnip
- Iron tablets- Other causes of GI bleeding e.g., bleeding gums or
gastric ulcer, drugs (aspirin, NSAIDs, corticosteroids)
3. British Society for Gastroenterology Guidelines for the management of Iron Deficiency Anaemia state that FOB testing is of no benefit in investigation, being both insensitive and non-specific.
4. Screening of appropriate groups of asymptomatic individuals is now offered through the UK Bowel Cancer Screening Programmes
Many thanks for your assistance in this matter.
Dr Webster MadiraHead of Service & Consultant Chemical Pathologist References 1. National Institute for Health and Clinical Excellence, Clinical Guideline 27. Referral
Guidelines for Suspected Cancer http://www.nice.org.uk/CG027niceguideline 20052. Goddard, FA et al. British Society of Gastroenterology.
Guidelines for the Management of Iron Deficiency Anaemia, 2005. 3. http://www.cancerscreening.nhs.uk/bowel
Withdrawal of Laboratory Faecal Occult Blood (FOB) Testing
Referrals from: GPs
EPAU Call direct on 0116 258 5241
Positive pregnancy test, Clinically stable, not requiring
urgent assessment
Clinical concern prompting immediate need for emergency
gynaecology or early pregnancy review and possibly admission
(If no answer on above number, call 0116 258 6105)
The EPAU number will be answered 24/7
Non-urgent Pregnancy Pathway Urgent Pathway
Call GAU0116 258 6305
Between 8am to 8pm weekdays and 9am to 1pm weekends - full medical team with consultant presence,
8pm to 8am weekdays and 1pm to 9am weekends - Clinical nurse specialist led service with support from
Resident on call medical team at registrar level.
If a GP wishes to consult with a senior clinician and there is not a member of the team immediately available then the person answering the phone will take the GP contact number and identify a senior Clinician to return the call
within 15 minutes
We are embarking on a new program to promote enhanced privacy and confidentiality. As part of the new Information Risk Governance programme we are placing a renewed emphasis of patient data quality. As part of this programme there are new standards for managing patient information including correspondence with every part of the health economy. This will also include an updated approach to dealing with discharge letters, clinic letters and pathology reports routinely shared with GPs.
Recent data incidents have highlighted that nearly a third of all post should not have been returned to us here at UHL, on investigation we are finding patients often registered at the practice we have sent mail to.
If you have any questions or require further information, please contact Jo’ Melbourne on 0116 258 6554.
Countdown:Change to units for HaemoglobinTo comply with Pathology Harmonisation from 1st September 2012 the units for Hb will change.
Results will be given in g/l not g/dl:
Example: Hb 10.2g/dl will become 102g/l
Protecting patient information
Did you know….• We receive around 4000 items of returned post per month
What staff within GP practices can do to help….
• Please ensure patients are checked thoroughly on clinical systems (including branch sites) to ensure before returning mail that the patient absolutely is not registered with the practice. It is important that patient care is not affected by potential delay in the actioning of results / requests for further investigations on patients who have had their mail returned to us in error
• We would encourage surgeries to report to any inaccurate data they receive to refer to the previously circulated returns process:
We are embarking on a new program to promote enhanced privacy and confidentiality.
• If a patient record is received at the practice not matched to a NHS number please attempt to match the patient manually – it is worth noting that new born babies will sometimes appear on your screen with no NHS number
If after in house checking an electronic letter / result has been received for a patient not registered with the practice please…
• Print off a copy of the letter / result and take a photocopy for your own records
• Send a copy of the letter / result to the provider which generated the letter by placing a copy in the hospital bag clearly marked with a note to say that the patient is not registered at the practice
• Reject the task in systm1 / ICE right click on the task, choose change status and choose delete. Practices please note the rejected task does not come back electronically to the hospital and so it is vital that a paper copy of the letter is printed and placed in the correct providers internal mail bag
For more information please contact Helen Jones, Quality & Safety Manager, on 0116 258 6008 or Robin Smith, Information Governance manager, on 0116 258 6053.
Returns processWhat to do if an electronic letter / result is received for a patient not registered at the practice
What you need to know….• Ambuline, working with Arriva Transport Solutions has been awarded a five-year contract for non-emergency patient transport (PTS) and has invested in 130 new vehicles. Most of the current EMAS PTS staff will transfer to Ambuline.
• EMAS will continue to take bookings and provide non-emergency patient transport until the changeover date.
• Non-emergency patient transport is booked only for people with a genuine medical need who cannot get to and from their appointments any other way. To ensure only patients with a genuine medical need receive NHS-funded transport, the eligibility criteria will be applied firmly, including those that allow escorts to accompany patients.
• Bookings will be made using the online booking system or by telephone, but not by fax. The option of providing patients with a telephone number to book their transport directly will remain in place.
• To reduce waits for patients, staff will book return journeys only after each patient’s appointment has finished. Returns can no longer be booked in advance.
• Arriva-Ambuline will have a telephone helpline from 1 July 2012, when the new booking number goes live (this will be communicated to you in due course).
Important Changes to Non-Emergency Patient Transport from 1 July 2012From 1st July 2012 EMAS will no longer be taking patients who meet the eligibility criteria, to and from NHS appointments.
July 2012
The LLR PCT Cluster is the commissioner of this service and as such should you have any queries you would like to raise please contact:Alison Hassell on [email protected] or Geoffrey White on [email protected]
PodcastsThe forth in a series of podcasts is focused on Chronic Kidney Disease.To watch and download (print / save) your CPD reflection form and certificate, please click here:
http://www.leicestershospitals.nhs.uk/EasySiteWeb/static/videos/gp_podcast_chronic_kidney_disease.wmv
Consultant updateJoinersMulugeta Zewdu ImagingMaria Fraser Pathology
Jeevendran Raj Imaging
Leavers
CKD: Self care for patients
And finally…For general information such as referring to us, GP education and previous editons of the GP newsletter, you can find it all (home or at work) by clicking here:
Education that involves and empowers patients is always beneficial and with this in mind we have developed a new and interactive way to get important information about self-care activities to patients attending kidney outpatient clinics.
We have developed and installed a Kidney information kiosk in out patient clinic 3 at the LGH which can be used by anybody wishing to get information about CKD.
Its becoming increasing important that patients with kidney disease understand their condition and the things they can do to improve their own health outcomes.
If patients have access to a computer and the internet they can register for ‘Renal Patient View’. Once connected they can see their latest blood test results, read clinic letters and view a range of other information about different aspects of kidney disease which allows people to feel more ‘in control’ of their health.
We have also developed a simple questionnaire that is given to each patient whilst they are waiting to see the doctor in the out-patient department. This highlights the important self care activities that are recommended for people with CKD, and encourages patients to use the kiosk to obtain relevant information and advice.
Patients can:
1. Access the information leaflets
2. E-mail leaflets to their home e-mail address
3. Request postal copies of the leaflets
4. Access important information links
5. Watch and request a DVD ‘Living with Kidney Disease’.
6. Request access to ‘Renal Patient View’
7. Give feedback to us about their visit and care received
• Endocrinology course
• Free Diabetes UK and UHL Event - Living with Diabetes
• Musculoskeletal Training for GPs
• Optimising Obstetric care
• Safe Surgery in Primary Care
• Schedule Of Digestive Diseases Seminars
• Update for primary care practitioners - sexual & reproductive health
We hope that the Kidney Information Kiosk project will:
• Improve knowledge and understanding of kidney disease with our patients
• Improve their ability to self care
• Promote shared decision making
• Improve health outcomes
• Reduce the risk of their disease progressing
For further information please contact Prof Sue Carror Coral Graham, Renal Research Nurse
GP EducationCurrently available for GP booking:
NHS Trust
University Hospitals of Leicester
